b'Over the last four years we have celebrated remarkableSince the early 1970s, Maryland has a statewide systemsuccess within our system. Our partnership withof EMS and cardiovascular care, coordinated by theJessamine County E911 has truly made a difference inMaryland Institute for EMS Systems (MIEMSS). The stateour community and the standards within ouris divided into five regions, with hospitals (both general department. Critical to these improvements has been theuse and specialty cardiovascular and cardiac arrest implementation of CARES. We now have critical andreceiving centers) distributed throughout the regions to timely reports that isolate our performance and ourallow systemwide distribution of the most critically ill impact on the community. The transparency of data thatcardiac arrest patients. CARES provides allows us to communicate with ourFoundation stakeholders, provide timely and necessary quality improvement, give critical feedback, and most of allMaryland takes a systems-based approach to EMS across celebrate our survival in a meaningful and positive way.the entire state. When Dr. R. Adams Cowley established Armed with this data, we have seen our Utstein Survivalthe state EMS system in the 1970s he stated: "According to JAMA, Standards for CPR and ECC . About 350,000 of increase from 12.5% (CY2019) to 25% (CY2022). In addition, because we submit dispatch data along withthese deaths occur outside the hospital usually within our EMS data, we have seen our Bystander CPR withtwo hours of the onset of symptoms. Thus sudden death . remains the gravest medical emergency today." Those dispatcher assistance increase from 9.4% (CY2019) to 36.6% (CY2022). These marked improvements could notwords are as true today as when they were first spoken, be accomplished without CARES. almost 50 years ago.CY2019CY2022From its inception, Maryland has initiated and grown astatewide EMS system, with a single EMS protocol and a Utstein Survivalsingle EMS patient care report. We have a statewide 12.5%25%network of Cardiac Intervention Centers to which cardiac Bystander CPR with9.4%36.6%arrests are transported and the latest patient care dispatcher assistancereport, eMEDS (an Image Trend product), is used in every one of the 24 counties and two cities across theJessamine County EMS continues to mobilize stakeholders and utilize CARES data to improve ourstate, completed in 2016. This formed the foundation for overall impact on the community. Through reliable,the rollout of CARES across the state in 2017. MIEMSS shares our performance and publishes Maryland\'s CARES accurate, and whole data with thoughtful leadership and deliberate execution, enhanced survival in Jessaminesurvival statistics each year in its annual report. County is inevitable. Maryland Resuscitation Academy Maryland: Working Toward a WorldThe Maryland Resuscitation Academy (RA), a network partner of the Resuscitation Academy in Seattle, put on its inaugural offering in 2012, with the help and support Where No One Dies of Cardiac Arrest By Kevin Seaman, MD, FAEMS, FACEP, Medical Director,of Seattle faculty, when there was a need for education Maryland Resuscitation Academyto save more lives in the eastern US. Over time, the Maryland RA, sponsoring two offerings a year, has Home to more than 6 million people, Maryland is locatedsuccessfully completed 35 RAs and educated more than in the mid-Atlantic region, stretching from the Atlantic1,800 graduates in life-saving techniques, travelling to seven states to spread these techniques more broadly.Ocean to the Appalachian Mountains, covering more than 12,000 square miles just north of Washington, D.C. and northern Virginia, and south of Pennsylvania. CentralFocusing on teaching letter-perfect CPR to EMS clinicians, while emphasizing implementation of the Ten Maryland is generally urban, while the remainder of the state is more rural. Steps to Improve Survival, we have witnessed the power of a team working together to save maximal lives.The Maryland RA has successfully completed 35 RAs and educated more than 1,800 graduates in life-saving techniques, travelling to seven states to spread these techniques more broadly.17'